Dollars and stents: A brave new world

• Reimbursement in the healthcare system is shifting from pure volume to a mixed volume/value‐based metric.
• Using complex statistical modeling to adjust for unknowns, the study provides real world data that the use of Co‐Cr EES is more cost effective than BMS assuming that clinicians select clopidogrel for P2Y12 inhibition.
• More cost‐effectiveness analyses should be conducted to guide the use of ever costlier novel medical devices and drugs.

     

Cerebral microbleeds: a guide to detection and clinical relevance in different disease settings

Cerebral microbleeds have emerged as an important new imaging marker of cerebral small vessel disease. With the development of MRI techniques that are exquisitely sensitive to paramagnetic blood products, such as T2*-weighted gradient-recalled echo and susceptibility-weighted sequences, microbleeds have been detected in ever-increasing numbers of patients in stroke and cognitive clinics, as well as in healthy older people and in a variety of other rarer diseases and syndromes. Detection of cerebral microbleeds has clinical implications with respect to the diagnosis of the underlying small vessel disease, the safety of antithrombotic use, and the risk of symptomatic intracerebral haemorrhage, cognitive impairment and dementia. This article provides a guide to the detection and clinical relevance of cerebral microbleeds in different conditions based on a comprehensive review of the literature and own findings in research and clinical practice.     

DNA interaction, antioxidant, and in vitro antitumor activity of binuclear ruthenium(III) complexes of benzothiazole-substituted ferrocenyl thiosemicarbazones

In our search for new anticancer drugs, a series of binuclear ruthenium(III) thiosemicarbazone complexes of the type [RuCl₂(EPh₃)]₂L (where E = P/As; L = binucleating monobasic tridentate thiosemicarbazone ligand) have been synthesized. Structural features were determined by various physico-chemical and spectral techniques. The interactions of these complexes with CT-DNA were investigated by absorption spectral study, indicates that the binuclear ruthenium(III) complexes form adducts with DNA and has intrinsic binding constant in the range of 1.0 × 10⁴–7.9 × 10⁴ M^?1. The free radical scavenging activity of binuclear ruthenium(III) complexes have been determined by their interaction with the stable DPPH free radical. All the complexes exhibited significant antiproliferative activity against human breast cancer line, MCF-7. This research may provide knowledge that is an excellent backdrop for the rational design of promising drugs.     

Clinical approach to hip pain

Hip joint pain occurs not uncommonly in clinical practice. Arthritis of the hip joint, ligament strain and bursitis are some of the common causes of hip joint pain encountered by physicians. This article dwells on relevant clinical anatomy of the hip and the diagnostic approach to hip pain in rheumatology clinic.     

Migrating foreign body into the common carotid artery and internal jugular vein – A rare case

Ingested foreign bodies are a fairly common otorhinolaryngological emergencies encountered in Malaysia. The vast majority of these foreign bodies are fish bones which most commonly are impacted at the level of the cricopharynx. Rarely, however, a foreign body may migrate extraluminally and may even extrude subcutaneously. We report a rare occurrence where a fish bone not only migrated extraluminally, it was found to have migrated into the common carotid artery and the internal jugular vein and required surgical removal.